The rise and fall of menopausal hormone therapy

Annu Rev Public Health. 2005;26:115-40. doi: 10.1146/annurev.publhealth.26.021304.144637.


Clinical trials show that hormone therapy (HT) is an effective treatment for vasomotor symptoms and vaginal dryness. HT improves other symptoms including sleep and quality of life in women who have menopause symptoms. In the Women's Health Initiative controlled clinical trials, both estrogen therapy (ET) and estrogen plus progestin therapy (EPT) reduced fracture risk, neither reduced the risk of heart disease, and both increased the risk of stroke, deep vein thrombosis, and dementia. EPT, but not ET, increased breast cancer risk and reduced colon cancer risk. Differences between EPT and ET may reflect chance, baseline differences between the EPT and ET cohorts, or a progestin effect. Studies of younger women and lower HT doses with intermediate endpoints are beginning.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Aged
  • Breast Neoplasms / chemically induced
  • Breast Neoplasms / epidemiology
  • Colonic Neoplasms / epidemiology
  • Colonic Neoplasms / prevention & control
  • Dementia / chemically induced
  • Dementia / epidemiology
  • Drug Prescriptions / statistics & numerical data
  • Estrogen Replacement Therapy* / adverse effects
  • Estrogen Replacement Therapy* / statistics & numerical data
  • Estrogen Replacement Therapy* / trends
  • Evidence-Based Medicine
  • Female
  • Fractures, Bone / epidemiology
  • Fractures, Bone / prevention & control
  • Humans
  • Menopause / drug effects*
  • Middle Aged
  • Osteoporosis, Postmenopausal / epidemiology
  • Osteoporosis, Postmenopausal / prevention & control
  • Public Health
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Stroke / chemically induced
  • Stroke / epidemiology
  • Time Factors
  • Treatment Outcome
  • United States / epidemiology
  • United States Food and Drug Administration
  • Venous Thrombosis / chemically induced
  • Venous Thrombosis / epidemiology
  • Women's Health